Spurred by inconsistent clinical recognition of sepsis, significant mortality, and lack of reliability of the current definition, the Sepsis-3 Task Force recently published a new approach to sepsis (1).

Sepsis was once believed to be the direct toxic effect of pathogens. The Sepsis-1 (1992) and -2 (2001) Task Forces argued, instead, that infection often kills through the body's inflammatory response. Coupled to this reframing was the hope that systemic inflammatory response syndrome (SIRS) criteria would identify patients with such a response. For 20 years, we have taught that the diagnosis of sepsis is based on having 2 or more SIRS criteria with an infectious source.